An analysis of the outcomes of Clostridioides difficile occurring in intestinal transplant recipients requiring hospitalization.
An analysis of the outcomes of Clostridioides difficile occurring in intestinal transplant recipients requiring hospitalization.
复制标题
对需要住院的肠道移植受者中艰难梭菌的结果进行分析。
DOI：
10.1111/tid.13951
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Jafri,Syed-Mohammed
中科院分区：
文献类型：
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作者：
Amjad,Waseem;Schiano,Thomas;Segovia,MariaC;Malik,Adnan;Weiner,Joshua;Horslen,Simon;Jafri,Syed-Mohammed
背景器官移植是艰难梭菌感染（CDI）的已知危险因素。关于CDI对肠移植人群影响的已发表数据有限。方法利用国家再入院数据库（2010-2017）研究有肠移植史患者的CDI结果。CDI与再入院和医院资源利用的关系在调整人口统计学和合并症的多变量模型中计算。结果2010-2017年，8442例有肠移植病史的住院患者被纳入住院索引。其中320人（3.8%）患有CDI。肠移植患者住院接受CDI治疗的中位成本比未接受CDI治疗的患者高54430(IQR:27231,109980) (IQR: 22 578, 112 777),(β: 71 814) 95%可信区间CI: 676-142 953， p=。048)。CDI患者的中位住院时间为7 （IQR: 4,13）天，而非CDI患者的中位住院时间为5 （IQR: 3,11）天（β: 5.51 95% CI: 0.73-10.29, p=）。02)。两组患者的死亡率、肠移植并发症、营养不良、急性肾损伤、ICU入院率和败血症相似。在指数入院期间，CDI是肠移植患者30天再入院的首要原因；从2010年到2017年，30天的再入院数量也有所增加。结论肠移植后CDI住院较为常见，且住院时间较长，住院费用较高。CDI是这些患者在CDI指数入院后再入院的最常见原因。
Background Organ transplantation is a known risk factor for Clostridioides difficile infection (CDI). There is limited published data on the impact of CDI in the intestinal transplant population. Methods We utilized the National Readmission Database (2010–2017) to study the outcomes of CDI in patients having a history of intestinal transplantation. Association of CDI with readmission and hospital resource utilization was computed in multivariable models adjusted for demographics and comorbidities. Results During 2010–2017, 8442 hospitalizations with the history of intestinal transplantation had indexed hospital admissions. Of these, 320 (3.8%) had CDI. CDI hospitalization in intestine transplant patients was associated with higher median cost 54430(IQR:27231,109980)ascomparedtopatientswhodidnothaveCDI 48 888 (IQR: 22 578, 112 777),(β: 71 814 95% confidence intervals CI: 676–142 953, p=. 048). The median length of stay was also longer for patients with CDI 7 (IQR: 4, 13) days as compared to 5 (IQR: 3, 11) days in non‐CDI (β: 5.51 95% CI: 0.73–10.29, p=. 02). The mortality rate, intestinal transplant complications, presence of malnutrition, acute kidney injury, ICU admissions, and sepsis were similar in both groups. CDI was the top cause of 30‐day readmission in the intestinal transplant recipients with CDI during the index admission; the number of 30‐day readmissions also increased from 2010 to 2017. Conclusion CDI hospitalization in post–intestine transplant patients occurs commonly and is associated with a longer length of stay and higher costs during hospitalization. The CDI was the most common cause of readmission after the index admission of CDI in these patients.